Dr. Peter Kelly:

I have to put this in lay terms. Both drugs work on the same receptor sites. When I talk to students, I say that methadone is like diesel and heroin is like rocket fuel. That is true in terms of its action and half-life.

My understanding is that it works on the same receptor sites, but it is just how quickly it goes in and out of the body and what kind of peaks and troughs there are. The advantage of methadone is once-a-day dosing, but it does take time to build up the plasma levels, whereas there are more peaks and troughs with pure morphine.

To go back to the Leas-Chathaoirleach's question about prisons, there is a big aspect to the prisons for data monitoring. As far as I know, the number of overdoses is not monitored. The data on the number of people coming in, and I stand corrected on this, who are dependent on opiates and get prescriptions is not there. I know, for example, that Mountjoy Prison had six addiction nurses. They do have counselling provided by Merchants Quay Ireland, but that does not mean people are going down on the wings and actively screening and assessing people who are dependent on opiates. From talking to nurses in the prisons, I know that people are left in prison in cells in withdrawals. Recidivism was mentioned. They then have to spend money on expensive drugs. Their relatives are on the hook in the community for hiding a gun or holding drugs and the cycle continues because they do not get the script in quickly. There were six in that particular area and now there is none. If you monitor and measure, you will start to see that things are done that are not being done. If a nurse were to prescribe, that additional time delay would be removed, because protocols are in place whereby prescriptions up to a certain amount of medication can be made without the presence of a doctor. A doctor still has to be consulted, however. If that is removed, an increase that is needed can be given on the spot, but it gives a lot more flexibility in terms of meeting the person's needs.